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<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<title>Регистрация | UP-SENSE</title>
<link rel="stylesheet" type="text/css" href="css/global.css">
<link rel="stylesheet" type="text/css" href="common/fonts/stylesheet.css">
<link rel="stylesheet" type="text/css" href="css/auth.css">
</head>
<body>

<form id="regformv1" action="formc.php">
<a href="#" class="reglogo"></a>
<h3>Персональные данные</h3>
<input type="text" id="laynormal"><label class="title_line">Имя</label><br/>
<input type="text" id="laynormal"><label class="title_line">Фамилия</label><br/>
<input type="text" id="laynormal"><label class="title_line">Отчество</label><br/>
<div id="uage"><label class="title_noapp">Дата рождения</label>
	<select class="day">
    	<option value="0" selected>--</option>
        <option value="1">1</option>
        <option value="1">2</option>
        <option value="1">3</option>
        <option value="1">4</option>
        <option value="1">5</option>
        <option value="1">6</option>
        <option value="1">7</option>
        <option value="1">8</option>
        <option value="1">9</option>
    </select>
    
    <select class="mounth">
    	<option value="0" selected>--</option>
        <option value="1">Январь</option>
        <option value="1">Февраль</option>
        <option value="1">Май</option>
        <option value="1">Апрель</option>
        <option value="1">Август</option>
        <option value="1">Сентябрь</option>
    </select>
    
    <select class="year">
    	<option value="0" selected>--</option>
        <option value="1">1989</option>
        <option value="1">1990</option>
        <option value="1">1991</option>
        <option value="1">1992</option>
        <option value="1">1993</option>
        <option value="1">1994</option>
    </select>    
</div>

<div id="country_town"><label class="title_noapp">Страна, Город</label>
<select class="country">
<option value="0" selected>--</option>
<option value="1">Украина</option>
<option value="1">Казахстан</option>
<option value="1">Россия</option>
<option value="1">Белорусия</option>
</select>

<select class="town">
<option value="0" selected>--</option>
<option value="1">Киев</option>
<option value="1">Харьков</option>
<option value="1">Минск</option>
<option value="1">Москва</option>
</select>
</div>

<div id="contact_info">
	<h3>Контактные данные</h3>
<input type="text" id="laynormal"><label class="title_line">E-Mail</label><br/>
<input type="text" class="teln"><label class="tel_num">Тел. номер</label><br/>
<div class="call_time"><label>Время звонка</label> 
	<span>C</span> <input type="text" pattern="[0-9]{2}:[0-9]{2}" placeholder="9:00">
	<span>До</span> <input type="text" pattern="[0-9]{1}:[0-9]{2}" placeholder="18:00">
</div>
</div>
<div id="refererid"><label class="title_noapp">ID <br><span>Пригласившего</span></label>
	<input type="text" maxlength="4"><input type="text" maxlength="4"><input type="text" maxlength="4"><input type="text" maxlength="4">
</div><br/>
<p class="reg_lic"><input type="checkbox">  <a href="#">Я принимаю условия пользовательского соглашения</a></p>
<input type="submit" id="submit" value="">
</form>

</body> 
</html>